Penile gangrene in a patient with poorly controlled type 2 diabetes Mellitus: a case report

Abstract

Author(s): Donat Cuni, Flatra Fetahu, Xhevdet Cuni*

Background: Ischemic penile gangrene is an uncommon manifestation of advanced vascular and metabolic disease. Because genital tissue necrosis can mimic or coexist with infection, malignancy, treatment-related injury, or other destructive processes, early clinical characterization is important. In this report, I will discuss the disease called distal penile gangrene in a person suffering from severe diabetes mellitus and existing ischemia of the lower extremities.

Case presentation: 67-year-old male with poorly controlled type 2 diabetes for more than 10 years was admitted to the hospital with the problem of gradual blackening of the penis glans. Patient suffers from severe lesion of vessels of the lower extremities and amputation of the right lower limb below the knee. In examination, dry gangrene was revealed on the surface of small focus without pus discharge, without affection of the testicles and lymphadenitis of inguinal lymph nodes. The level of HbA1c is 13%. After consultation of multidisciplinary team and preparation of the patient in optimal condition, necrotic lesion of glans penis was surgically removed. Opening of urinary tract was restored with insertion of catheter in urethra. Recovery from the surgery was adequate to be classified as positive, and there were no complications in the early postoperative period. Upon completion of rehabilitation therapy, the patient was transferred to a special unit with prolonged care.

Conclusion: Distal penile gangrene must be assessed for the presence of underlying systemic disorders of the vascular system and excluded any infections and other factors causing necrosis. Tissue-preserving surgery may restore urinary function in the presence of necrotic tissue in certain locations and with well-defined borders. Differentiation of ischemic necrosis from non-ischemic lesions of the penis is very important for further diagnostic approach in case of malignancy of the penis.

Share this article